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Fentanyl Nasal Spray

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IMPORTANT WARNING
Fentanyl nasal spray should only be prescribed by doctors who are experienced in treating pain in cancer patients. It should be used only to treat breakthrough cancer pain (sudden episodes of pain that occur despite around-the-clock treatment with pain medication) in cancer patients at least 18 years of age who are taking regularly scheduled doses of another narcotic (opiate) pain medication, and who are tolerant (used to the effects of the medication) to narcotic pain medications. This medication should not be used to treat pain other than chronic cancer pain, especially short-term pain such as migraines or other headaches, pain from an injury, or pain after a medical or dental procedure. Fentanyl nasal spray may cause serious breathing problems or death if it is used by people who are not being treated with other narcotic medications or who are not tolerant to narcotic medications. [More...]
Why is this medication prescribed?
Fentanyl nasal spray is used to treat breakthrough pain (sudden episodes of pain that occur despite round the clock treatment with pain medication) in cancer patients 18 years of age or older who are taking regularly scheduled doses of another narcotic (opiate) pain medication, and who are tolerant (used to the effects of the medication) to narcotic pain medications. Fentanyl is in a class of medications called narcotic (opiate) analgesics. It works by changing the way the brain and nervous system respond to pain.

How should this medicine be used?
Fentanyl nasal spray comes as a solution (liquid) to spray in the nose. It is used as needed to treat breakthrough pain, but not more often than four times per day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Your doctor will start you on a low dose of fentanyl nasal spray and gradually increase your dose until you find the dose that will relieve your breakthrough pain. Talk to your doctor about how well the medication is working and whether you are experiencing any side effects so that your doctor can decide whether your dose should be adjusted. If you still have pain 30 minutes after using fentanyl nasal spray, your doctor may tell you to use another pain medication to relieve that pain, and may increase your dose of fentanyl nasal spray to treat your next episode of pain. Do not increase your dose of fentanyl nasal spray unless your doctor tells you that you should.

Do not use fentanyl nasal spray more than four times a day. Call your doctor if you experience more than four episodes of breakthrough pain per day. Your doctor may need to adjust the dose of your other pain medication(s) to better control your pain.

Fentanyl nasal spray may be habit forming. Use fentanyl nasal spray exactly as directed. Do not use a larger dose, use it more often, or use it for a longer period of time than prescribed by your doctor.

Do not stop using fentanyl nasal spray without talking to your doctor. If you suddenly stop using fentanyl nasal spray, you may experience unpleasant withdrawal symptoms.

To use fentanyl nasal spray, follow these steps:
Other uses for this medicine
This medication should not be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before using fentanyl nasal spray,
What special dietary instructions should I follow?
Do not eat grapefruit or drink grapefruit juice while using this medication.

What should I do if I forget a dose?
This medication is usually used as needed according to directions.

What side effects can this medication cause?
Fentanyl nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: Some side effects can be serious. If you experience this symptom, call your doctor immediately: If you experience any of these symptoms, stop using fentanyl nasal spray and call your doctor immediately or get emergency medical treatment: Fentanyl nasal spray may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What should I know about storage and disposal of this medication?
Store fentanyl nasal spray in its child-resistant container, tightly closed, and out of reach of children. Store the child-resistant container and pouch in the cardboard box it came in when not in use. Store fentanyl nasal spray in a safe place so that no one else can use it accidentally or on purpose. Keep track of how many sprays in each bottle are left so you will know if any are missing. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom). Do not freeze fentanyl nasal spray.

Dispose of fentanyl nasal spray as soon as it becomes outdated or is no longer needed. Dispose of any bottle of fentanyl nasal spray if 5 days have passed since you last used it or if 14 days have passed since you prepared the bottle for its first use. You can safely dispose of fentanyl nasal spray by spraying remaining liquid into the pouch provided with the medication, as described in the Medication Guide. The sealed pouch and empty bottle should then be placed in the child-resistant container before putting it in the trash. Wash your hands with soap and water right away after handling the pouch. Call your pharmacist or the manufacturer if you have questions, need help disposing of unneeded medication, or do not have a pouch available.

In case of emergency/overdose
In case of overdose, call local emergency services at 911.

Symptoms of overdose may include the following:
What other information should I know?
Keep all appointments with your doctor.

Do not let anyone else use your medication, even if he or she has the same symptoms that you have. Selling or giving away this medication may cause severe harm or death to others and is against the law.

This prescription is not refillable. Be sure to schedule appointments with your doctor on a regular basis so that you do not run out of medication.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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Last Revised - 09/15/2012
© 2014. The American Society of Health-System Pharmacists, Inc.
ASHP
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